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General NPI Number Information
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NPI Number | 1386528859
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Entity Type | Individual
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Provider Name | SAVANNAH MICHELLE TIBBETTS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 965 WHITE PLAINS RD
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City | TRUMBULL
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State | CT
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Zip | 06611-4502
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Country | US
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Telephone | 203-261-2541
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Fax |
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Provider Business Mailing Address
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Address Line | 11 NORTHWOOD RD
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City | MONROE
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State | CT
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Zip | 06468-2227
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Country | US
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Telephone | 203-623-5578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0017046
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License Number State | CT
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